A few weeks ago,Vermont Governor Peter Shumlin dedicated his State of the State address to addiction.
In every corner of our state, heroin and opiate drug addiction threatens us. It threatens the safety that has always blessed our state. It is a crisis bubbling just beneath the surface that may be invisible to many, but is already highly visible to law enforcement, medical personnel, social service and addiction treatment providers, and too many Vermont families. It requires all of us to take action before the quality of life that we cherish so much is compromised.
At work we talk about treating people struggling with addiction. We have some great programs to help and part of my job is to spread the word about these programs.
The nature of the addiction problem came to light recently in a communications meeting. We were tracking various news stories and saw one about Philip Seymour Hoffman. One of the guests cited some report which claimed that two out of three Americans are affected by addictions amongst their friends or family. I looked around the room. Everyone is the room had someone close to them that was struggling with addiction. That two in three number may be a bit low.
Today, a friend shared the article, Russell Brand: my life without drugs. Please, go out and read it.
At CHC, we provide telemedicine services to help providers around the country provide better services for those struggling with addiction. Project ECHO - Buprenorphine helps primary care providers treat patients struggling with opioid addiction. It brings together experts in several fields to provide both experiential and didactic education in treating addiction.
Our outreach teams work on a related issue, health stigmas. How do we reduce the stigmas around various health conditions, like suffering from addiction or being HIV positive? How do we make it easier for people to get the treatment they need?
We celebrate when our friends are in remission from cancer, knowing in the back of our minds that it could come back at any moment. Why don’t we have similar celebrations for friends in recovery from addiction? Yes, there may be some celebrations at a narcotics anonymous meeting or something like that, but we are a long way from standing with people fighting health problems the way we should.
This morning, my Chromebook was acting weird, sluggish. It wouldn’t save what I was writing. In the end, I lost a draft of a blog post which I had put a lot of work in. It’s just one more thing in what is been a frustrating few days. Yesterday, one of the dishes from my mother’s house, from my childhood, broke. Things have been very stressful at work. Blah.
Anyway, I had started my blog post reflecting on Groundhog’s Day. It may be that Punxsutawney will see six more weeks of winter, or perhaps those in the media spotlight will continue to experience cold slippery conditions, but any woodchuck here in Woodbridge would have difficulty seeing much beyond the end of his burrow, let alone his shadow.
The top news story of the day that Google News select for me was about Gov. Christie’s letter to his supporters. The whole thing reads like he is helping write the libretto for Christie and the GWB, an opera on the scale of Einstein on the Beach,Nixon in China, or perhaps Brokeback Mountain.
The next story was about the Super Bowl. I wonder how many people will be talking about Gov. Christie as they drive across the George Washington Bridge on their way to the big game. I expect traffic will be pretty bad.
Buried much deeper in the news was reports that the death toll has now risen to 16 in the volcano in Indonesia.
Yesterday, Dan Kennedy posted a status on Facebook, talking about the State Department report on the XL Pipeline. It has now received fifty six comments, most of them very insightful well thought out about climate change, transportation, cost benefit analysis, stakeholder analysis and so on.
It provided an interesting data point with which to think about Howard Rheingold’s video, Why the history of the public sphere matters in the Internet age. This is a video that was posted back in 2009 and recent reappeared in my social media feed. It has lots of interesting ideas to explore, and I’d love to hear thoughts about it five years later.
Was the discussion around Dan’s post a good example of the public sphere online? Was it an anomaly? What can we learn from it? I was planning to write more on this after I took a break to go to the dump. On the way, I listened to David Sedaris on NPR reading his New Yorker article, Now We Are Five.
It was a moving recounting of issues in his family and it made me stop and think. Is it the public sphere that we need to be thinking about, or is there something bigger, something more important? What about an empathetic sphere? What about a creative sphere? How do these spheres relate to one another? Do the overlap? Does one encompass another? They they part of some giant three dimensional Venn Diagram?
What does this public creative empathetic sphere look like and how does it behave? It’s still foggy outside, and I’m not really sure. So, I’ll get ready and head off to church for Candlemas.
Yesterday, in response to the mall shooting in Maryland, a friend on Facebook talked about her experiences working in mall security in North Carolina. In the comments, people discussed the role of guns in American society, but she replied,
I just don't think this is about guns.
Something ELSE is wrong...
there is something new wrong with us.
And we need to figure out what it is.
I would like to suggest that there are, perhaps, several things happening in our world today that have come together to create this deadly climate.
The first issue, I think, is economic uncertainty. Here in the United States, and around the world, we’ve seen difficult economic circumstances. The meltdown of American financial institutions and the great recession. Financial difficulties in Europe and austerity budgets. When people think about the Arab Spring, they too often overlook the self-immolation of an impoverished worker in Tunisia which acted as a catalyst for the major changes there. Today, economic disparities appear to be getting worse and worse, and everyone is fighting to hold on to what they have.
Yet this is nothing new. The Weimar Republic was known for its economic difficulties as well. Let’s hope we don’t go down that road again.
Changes in our world, like the globalization of trade and climate change throw additional monkey wrenches into economic stability.
People who have studied Marx may feel inclined to link some of what is going on the Marx’s theory of alienation.
Alienation (Entfremdung) is the systemic result of living in a socially stratified society, because being a mechanistic part of a social class alienates a person from his and her humanity. The theoretic basis of alienation within the capitalist mode of production is that the worker invariably loses the ability to determine his or her life and destiny...
Although the worker is an autonomous, self-realised human being, as an economic entity, he or she is directed to goals and diverted to activities that are dictated by the bourgeoisie, who own the means of production, in order to extract from the worker the maximal amount of surplus value, in the course of business competition among industrialists.
It is not surprising to see people lash out against a loss of ability to determine their destiny in violence.
This is further complicated by the increased role of money in politics. As economic disparity increases, the voice of all but the richest few get drowned out, and the richest use their money to have laws and policies instituted that protect or even expand their wealth. This in turn leads to greater alienation and greater probability of violence.
Related to this is how poverty fuels racism and homophobia. As poor undereducated people suffer from the economic disparities and alienation, they look for someone to lash out against. In the Weimar Republic, it was the Jews who were the primary victims of this out lash, although homosexuals and trade unionists were also lashed out against.
Here in twenty first century America, with homosexuals finally gaining equal rights to marry and with a mixed race President, people of color and homosexuals are a frequent target of these outlashes.
Yet there is one more factor, that is very important, and that is the changing media landscape. Again, we see the effect of money in politics as it relates to the political landscape. Large media corporations benefit from the money in politics and they seek to shape politics through their programming to protect their economic interests.
At the same time, we have Internet communications becoming more prevalent. Ten years ago, the media went after Gov. Howard Dean in his Presidential campaign by the now infamous misrepresentation of the ‘Dean Scream’. They took one of Dean’s campaign slogans, “You have the power” and appropriated it to themselves, asserting that the Washington Press Corps is really who has the power.
Now, as you look at discussions online, they are becoming more and more stratified and confrontational. We are living in filter bubbles’, where we don’t interact with people with other beliefs, except to yell at them.
Anyone who has read the anonymous comments on a newspaper website or watch Sunday morning cable news shows shouldn’t be surprised at the increase of violence in our country.
As the world gets smaller, the growing economic disparities become more apparent, and we see more violence.
The question is, how much worse will it get before we see a turning of the tide and a decrease in violence? What will it take to refocus from the culture wars to the effect that class wars are having on our society?
I don’t know, but I’m heading off to a church that is focused on feeding and housing the poor, and not on passing judgment on people because of the color or sexual orientation.
Yesterday, I attended a presentation on the use of tablets in health screenings. It is a project CHC has been involved with together with UConn and another health care organization and it is funded in part by the Connecticut Health Foundation.
One of the comments that particularly jumped out at me was about research that questions the effectiveness of many earlier screening programs. The problem is that these screenings often took upward of an hour and were not necessarily all that accurate.
By using tablets with targeted screenings that the patient could do, typically in four to seven minutes on a tablet while waiting for an appointment, the researchers found much greater accuracy and patient satisfaction with the screenings.
Earlier in the day, I had read an article in the New Yorker, THE DEFIANT PARENTS: TESTING’S DISCONTENTS. It was a fascinating article.
The article is full of great quotes, “One teacher remarked that, if a tester needs three days to tell if a child can read ‘you are either incompetent or cruel…’” Applying it to health care, any practice that took frustrating grueling days to administer basic tests would quickly find themselves out of business.
Part of the Affordable Care Act was the creation of the Patient-Centered Outcomes Research Institute. Perhaps, as part of education reform, we need to look at student centered outcomes research. How effective are the existing batteries of standardized tests? Are there better testing methodologies? Are the components of the core curriculum really the components that will result in the best life outcomes for the students? How does the core curriculum relate to twenty first century skills? Is the focus on the core curriculum diminishing the focus on other key 21st century skills, like creativity and collaboration?
This ties back to one of the lines in the New Yorker article,
Allanbrook says that her decision to speak out was motivated in part by thinking about the fifth-grade social-justice curriculum at the school, in which children who are about to graduate are asked to consider the question “What are we willing to stand up for?”
That especially jumped out at me. Does the school your children go to have a social justice curriculum? It seems like such a curriculum may a great example of what needs to be taught to reach twenty first century skills, and getting skipped because of excessive focus on the core curriculum.
To return to the topic of testing, the article talks about a testing process which takes “seventy minutes a day for six days” and contrasting it with “alternative tests produced by the Department of Education, one in English language arts and one in math, each lasting just forty-five minutes”.
There is another of aspect of health care that jumps out at me which I’ll introduce by way of the infamous quote from the Harvard Educated son of a University of Chicago Secretary of Education, Arne Duncan, who
described critics of the Common Core as “white suburban moms who—all of a sudden—[find] their child isn’t as brilliant as they thought they were, and their school isn’t quite as good as they thought they were.”
Yes, I am white and suburban, though I’m a father, not a mother, and I have not found any of my three daughters any less brilliant than I thought they were. The older two both skipped high school to start college at fourteen. The eldest is teaching English in Japan and the middle daughter completed her Masters in Education at age 19 and has already published three books, her most recent pointing out issues with an education system that does not sufficiently promote creativity. The youngest who is attending a great public elementary school consistently is a top scorer on standardized tests.
Besides relying on false stereotypes, the biggest problem I have with Sec. Duncan’s quote is that it reflects a different issue with the core curriculum.
In health care, we have the National Culturally and Linguistically Appropriate Services.
Provide effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.
One of the criticisms of standardized testing is that many such tests have been culturally biased. Is enough being done to address cultural biases with the core curriculum? Do these cultural biases also end up in the classroom as teachers “teach to the test”? Concerns about the cultural aspects of education are just one part of the larger concern about the ‘one size fits all’ aspect of the core curriculum. Should the requirements vary depending on a students learning style? Does it really matter at what age geometry is learned and at what age algebra is learned, or does what really matter is that adequate progress is made towards learning all the aspects of the core curriculum by high school graduation?
Perhaps Ken Robinson’s comment about ‘date of manufacture’ addresses this issue best
We still educate children by batches. You know, we put them through the system by age group. Why do we do that? You know, why is there this assumption that the most important thing kids have in common is how old they are. You know, it's like the most important thing about them is their date of manufacture.
Well I know kids who are much better than other kids at the same age in different disciplines. You know, or at different times of the day, or better in smaller groups than in large groups or sometimes they want to be on their own.
If you are interested in the model of learning you don't start from this production line mentality. This is essentially about conformity. Increasingly it's about that as you look at the growth of standardised testing and standardised curricula. and it's about standardisation. I believe we've got go in the exact opposite direction. That's what I mean about changing the paradigm.
As a final note, plenty of people have criticized the Affordable Care Act. It doesn’t do enough to reform health care and perhaps some of the reforms are headed in the wrong direction. We do need to improve the Affordable Care Act while recognizing benefits that it brings.
It seems as if the same applies to education reform. We do need a core curriculum, one that really addresses the twenty first century skills our students will need. We need proper testing and scientific research into how well these skills are being taught, the impact they are having, and even on the impact of testing, and we need to introduce ideas like the CLAS standards to education and move away from a one size fits all approach to testing and education.
Back to the starting point of this blog post, research at CHC has found that by coming up with new approaches to health screening, effectiveness and satisfaction can be improved. We need to look at similar ways to do this for education, perhaps individualizing and gamifying the whole process.
So, I asked my twelve year old daughter, “What if we replaced standardized tests with computer games?”
Her response was, “That would be awesome!” and then we went on to discuss how people could use it, track student and school performance and play the games from home.
Saturday morning, the leading edge of the winter storm had arrived. It was still just snowing lightly, but it had already snowed enough to make the roads messy. Because of events on the previous weekends, it had been a couple weeks since I had made it to the transfer station and I really wanted to go before the weather got bad.
These days, every big storm brings up the topic of climate change. Yes, it had snowed recently in Egypt, for the first time in over one hundred years, but nothing seemed out of the ordinary with this storm.
On the radio, Scott Simon had talked about the drama around the production of RENT in Trumbull RENT has been much on my mind these past several days.
After dropping out of college back in 1980, I moved to New York with a couple friends. We lived in an old spice factory that had been converted to loft space in Brooklyn. One of my roommates was a painter who was working on a masters degree at NYU. Another was a photographer who was a food service manager at CBS’ broadcast center, and a third was a sculptor trying to find some way of making it in the big city. Upstairs, there were dancers. I aspired to write poetry and supported myself writing computer programs.
It was not ‘La Vie Boheme’ from RENT, but it came close. I met pushers and pimps, prostitutes and junkies. I remember the first time I saw someone shooting up in a car on 2nd street when we went to visit friends in the east village. Safely up in the apartment we sang Neil Young’s “Needle and the Damage Done.”
A couple years later, I left to spend eight months hitchhiking around the States and Europe. I stayed with friends of a friend in San Francisco and walked down a quiet Castro street in 1983. AIDS was on everyone’s mind.
When I came back, I live for a while with actors on Mott St in Little Italy and spent time talking with the old WW II and Korea veterans who drank Wild Irish Rose as they sat on the steps of the laundromats not far from the Bowery. One of those actors was from Greenwich, which now has already produced the High School version of RENT. ANother was from Trumbull. I don’t know if his folks still live in Trumbull, or what he thinks of what is going on there now.
Somehow, we all made it through those turbulent times. I got married, started a family and moved to Connecticut. It wasn’t until the nineties that I knew someone who died from AIDS. A friend of mine was gay. He didn’t tell people because he was afraid he might lose his job. His partner of 14 years had contracted AIDS and I remember doing the little I could to help.
A couple years later, my first wife left me. It was devastating to me. She got a job teaching theatre and moved to Trumbull. She still teaches at a private school in Connecticut. I haven’t spoken with her about what is going on in Trumbull, but I suspect she sees these sort of conflicts more than she would like.
During my reminiscences the song from RENT, “Light My Candle”, came to mind. I remarried. Fortunately a less tumultuous relationship than that of Roger and Mimi and she still lights my candle thirteen years later.
On my way home from the transfer station, after unloading my trash, I listened to the special coverage of the one year anniversary of Sandy Hook. I listened to the bells toll from Asylum Hill as a professor from Hartford Seminary talked about grief, hope, forgiveness and community. She spoke eloquently about what she heard in each bell toll, children’s laughter, gun shots, screams. tears, the tears of parents, of the community, of the world. They talked about other lives that have been lost to gun violence.
The words of John Donne came to mind.
Any man's death diminishes me,
Because I am involved in mankind,
And therefore never send to know for whom the bell tolls;
It tolls for thee.
It’s been a year. My mind goes back to RENT. 525,600 minutes. Seasons of Love. How do you measure a year?
In truths that she learned
Or in times that he cried
In bridges he burned
Or the way that she died
High school was hard for me. Not academically, I got good grades good test scores and was an honor student. But I was socially awkward and my parents separation and our financial difficulties weighed heavily on me. It was things like high school musicals that helped me through those difficult years.
A few years back, I found that there are municipalities near Trumbull where the median household income is over $200,000 and other municipalities where the median household income is less than a tenth of that. Sandy Hook is just a few towns away.
In the discussions of Sandy Hook, people often ask, who failed. Why didn’t the gunman or his mother get the help that they needed?
Was it because the school administration and the members of the community were unwilling or unable to confront challenging topics? I’m not saying that a tragedy like Sandy Hook is likely to happen in Trumbull because of overly cautious administrators, but I do believe we need to look closely and see how the actions of the current administration in Trumbull relates to other failures in education and community across our country.